Print version ISSN 0004-282X
Arq. Neuro-Psiquiatr. vol.70 no.1 São Paulo Jan. 2012
Escala de gravidade e habilidade funcional em pacientes com esclerose lateral amiotrófica. (Resumo)
Marco Antonio Orsini
Departamento de Neurologia, Universidade Federal Fluminense (UFF), Rio de Janeiro RJ, Brazil, 2011
INTRODUCTION: Amyotrophic lateral sclerosis (ALS) is a progressive, degenerative disease that leads to the motor neurons depletion in the spinal cord anterior horn and pyramidal tract. Several evaluations have been proposed in order to provide a better follow-up and management of secondary complications. However, the biggest difficulty is to select a single instrument to objectively assess the neurological deficit, the functional independence level and, above all, one which will include such subjects in specific severity stages.
OBJECTIVE: To present a new tool for clinical and functional evaluation for ALS patients, the Severity and functional ability scale (SFAS), and discuss the clinical and functional profile of 98 patients between March 2007 and December 2009 at Antonio Pedro University Hospital (UFF) and the Deolindo Couto Institute of Neurology (UFRJ).
METHOD: We used the SFAS as clinical and functional indicator. The modified El Escorial criteria were used to establish the diagnosis. The participants underwent a number of five quarterly assessments during the study period of one year.
RESULTS AND DISCUSSION: The average age of the study group was 52.67 years±12.043 years. The average time between the onset of first symptoms and seeking care services was 11.57±12.391 months. The average time between first symptoms and the diagnosis was 20.54±8.413 months. Of the 98 subjects tested, only 24 have completed all phases of the study. Muscle weakness was identified as the initial symptom in most cases. The patients showed progressive impairment of muscle strength, speech, swallowing, breathing and the severity stages. The disease was marked by different forms of initial presentation (speech, limbs, breathing, swallowing), progression speed and diverse clinical characteristics in our population.
CONCLUSION: Knowledge of the clinical and functional ALS peculiarities, obtained by applying the SFAS, serves as a guide for proper monitoring of patients during the development stages and encourages the formulation of a theoretical-conceptual framework, aiming at solving problems in clinical practice.
Key words: amyotrophic lateral sclerosis, motor neuron, epidemiology.
Marco Antonio Orsini
Herotides de Oliveira 2/801
24230-230 Niterói RJ - Brasil
Orientador: Prof. Dr. Marcos Raimundo Gomes de Freitas.
Co-orientador: Prof. Osvaldo JM Nascimento.